Hale Goksever Celik, MD

Dr. Goksever Celik is an obstetrician and gynecologist, graduated from the medical school of the Hacettepe University in Ankara, and trained through Obstetrics and Gynecology fellowship at Dokuz Eylul University in Izmir. She has been a postdoctoral research fellow at Molecular Biology and Genetics at Istanbul University. She has been participating in several research especially interested in the association between endometriosis surgery and ovarian reserve and the genetic basis of endometriosis.

Endometriosis and Physical Activity

Endometriosis causes abstinence from their daily life, especially during painful periods. Decreased physical function might result in reduced physical activity. Sachs et al., from Switzerland, published a study titled “Physical Activity in Women with Endometriosis: Less or More Compared with a Healthy Control?” in the International Journal of Environmental Research and Public Health. The authors aimed to investigate the effect of endometriosis on physical activity, compared to women without any suspicious signs of endometriosis in this multi-center, cross-sectional study. Demographic and…

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Treatment of superficial dyspareunia using topical estrogens in postmenopausal women with a history of endometriosis

Genitourinary syndrome of menopause is defined as a collection of symptoms and signs caused by hypoestrogenic changes to the labia majora/minora, clitoris, vestibule/introitus, vagina, urethra, and bladder that occur in menopausal patients. Sexual dysfunction and superficial dyspareunia can be experienced by postmenopausal women resulting in decreased quality of life. Hormonal or non-hormonal treatments (lubricants/moisturizers) may be prescribed to manage vulvovaginal atrophy-associated superficial dyspareunia. It should be known that there are some special populations, such as women with a history of endometriosis:…

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Preoperative flexible sigmoidoscopy in patients with deep infiltrating endometriosis

Deep infiltrating endometriosis is defined as endometriotic lesions extending 5 mm or more below the peritoneal surface. Women with deep endometriosis have rectovaginal lesions affecting the tissue adjacent to, or directly involving the rectum and/or rectosigmoid colon with a 90% incidence. Deep endometriosis may be diagnosed or suspected with transvaginal ultrasound or magnetic resonance imaging in experienced hands. Routine flexible sigmoidoscopy is suggested in cases with suspicious rectovaginal deep endometriosis. Sewell et al., from the United Kingdom, published a study titled “The…

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Moderate-to-severe Endometriosis and "The Cumulative live birth rate" in IVF Cycles

Infertility is one of the major symptoms in women with endometriosis. The incidence of endometriosis is approximately 10% in reproductive-aged women and up to 40-50% in infertile women. There are multifactorial mechanisms resulting in endometriosis-associated infertility such as anatomic distortion, impaired tubal and sperm motility, and diminished endometrial receptivity. Dr. Zimmermann et al, from France, published a study titled “Impact of moderate-to-severe endometriosis on IVF cumulative live birth rate: a retrospective matched cohort study” in the journal "Reproductive BioMedicine Online". The…

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Are women with endometriosis more prone to pregnancy loss?

Endometriosis is a gynecological disease of reproductive-aged women who may suffer from reproductive outcomes such as infertility, miscarriage, and recurrent pregnancy loss. Pregnancy loss is the spontaneous loss of a pregnancy until 22 weeks of gestation including spontaneous abortion, missed abortion, and gestational sac without a fetus; while recurrent pregnancy loss is defined as three consecutive pregnancy losses. Dyhrberg Boje et al, and associates from Denmark, published a study titled “Endometriosis is associated with pregnancy loss: a nationwide historical cohort…

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Endometriosis and Genetic Polymorphisms in Proinflammatory Cytokines

Several pathophysiological mechanisms have been proposed for the chronic inflammatory nature of endometriosis, such as retrograde menstruation, coelomic metaplasia, hormonal change, oxidative stress and inflammation, immune dysfunction, and apoptosis suppression. One of the most widely accepted theories in recent years is inflammatory dysfunction and genetic polymorphism. Babah et al., a research group from Nigeria and the UK, published a study titled “Serum concentrations of IL‑16 and its genetic polymorphism rs4778889 affect the susceptibility and severity of endometriosis in Nigerian women”…

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Changes over time in day surgery for endometriosis in Canada

There are several medical and surgical treatment options for the management of endometriosis. Surgical approach is generally preferred in women with atypical endometrioma appearance on ultrasound, and who have persistent pain despite medical treatment. Surgery is often the first choice for endometriomas with rapid increase in size. Bahrami et al., from Canada, published a study titled “Day surgery for endometriosis in Canada: A retrospective cohort of trend and regional variation in types of surgeries and their complications” in the journal…

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Meningioma risk in women with endometriosis using Nomegestrol acetate

Women with endometriosis mostly suffer from symptoms such as chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Early diagnosis and management have importance as endometriosis impairs the quality of life and creates a serious social and economic burden. There are different medical treatment options including only progestogens, oral contraceptives, or gonadotropin-releasing agonists/antagonists. Combined oral contraceptives are a good modality if women request contraception or progestogen monotherapy is associated with breakthrough bleeding or bone mineral density reduction. The standard progestogen in oral…

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Does ovarian endometrioma affect embryo aneuploidy rate in fertile women?

One of the most common clinical findings of women with endometriosis is the decline in fertility status. These women often benefit from in vitro fertilization methods to become pregnant. However, whether there is a detrimental effect of endometriosis on oocyte and embryo development following in vitro fertilization treatments is a controversial issue. A group of scientists under the leadership of Dr. Yuan from China published a study titled “Ovarian endometrioma increases the embryo aneuploid rate: an analysis of 7092 biopsied blastocysts…

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The effect of dienogest vs ethynyl estradiol/dienogest on quality of life in women with endometriosis

Women with endometriosis suffer from dysmenorrhea, dyspareunia, and chronic pelvic pain that diminishes the quality of their life. Both physical and mental components of quality of life have been affected by endometriosis-associated symptoms. There are several medical and surgical treatment options to manage these women. However, none may provide a permanent solution to increase the quality of life. Maiorana et al. from Italy published an observational single-center study titled “Quality of life and clinical factors in women with endometriosis, the…

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Endometriosis diet and the quality of life

Women with endometriosis suffer mainly from pelvic pain which results in a negative effect on the quality of life. Although several treatment options have been proposed, some endometriosis patients still have poor quality of life due to pelvic pain. Upon this, research has begun to evaluate the benefits of the gluten- and sugar-free endometriosis diet. van Haaps and colleagues from the Netherlands published a study entitled “A better quality of life could be achieved by applying the endometriosis diet: a cross-sectional…

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The #Enzian classification, an essential tool for surgical management of severe endometriosis

The lecture entitled "The #Enzian classification, an essential tool for surgical management of severe endometriosis" was presented by Professor. Jörg Keckstein, from the University Ulm, Germany, at the Annual International Medical Conference of the Endometriosis Foundation of America held in New York on April 1-2, 2023. Endometriosis is a disease that requires classification due to the heterogeneous and complex nature of the disease. Such a classification system will also enable communication between clinicians, surgeons, and patients. The Revised American Society for Reproductive Medicine…

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First-line surgery or first-line ART: A real challenge both for the clinicians and infertile women having DIE without colorectal involvement

Deep infiltrating endometriosis (DIE) is defined as the presence of endometriotic lesions over 5 mm in depth under the peritoneal surface. These women suffer from chronic pelvic pain, dysmenorrhea, dyspareunia, chronic pelvic pain, bloody or painful bowel movements, and infertility. There is a dilemma about whether the treatment of infertility should be primarily surgery or ART in DIE-associated infertility. Ferrier et al., from France, published a review titled “First-line surgery vs first-line ART to manage infertility in women with deep endometriosis…

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The enhanced invasiveness, migration and the development of adenomyosis: Importance of M2 macrophages

Adenomyosis is the ectopic presence of endometrial stromal and glandular cells inside the myometrial tissue. Adenomyosis is diagnosed in women with gynecological problems with an incidence of 20%, although it is encountered much more frequently in hysterectomy specimens. Among many theories proposed as the reason for adenomyosis development, the most accepted one is the invasion of the myometrium by the eutopic endometrial basalis via a traumatized endometrial-myometrial junctional zone. It is also confirmed that immunological dysregulation is important for endometrial…

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Postoperative pregnancy outcomes in women with deep infiltrating endometriosis

Subperitoneal invasion of endometriotic lesions exceeding 5 mm in depth is named "deep infiltrating endometriosis' and can be located on uterosacral ligaments, in the intestine, vagina, bladder, and ureter. Women with deep infiltrating endometriosis suffer from pelvic pain and infertility most commonly and demand treatment to increase the quality of their life. Although management is individualized depending on the patient’s symptoms and pregnancy wish, the first-line treatment is hormonal therapy, especially in women with pelvic pain. However, medical treatment has no…

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Comparison of different IVF stimulation protocols for pregnancy success in infertile endometriosis patients

Women with endometriosis may suffer from reproductive problems up to an incidence of 50%. Several pathophysiological mechanisms including anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis and sperm movements are the most responsible for the development of endometriosis-associated infertility. Assisted reproduction technology (ART) is the most frequently preferred treatment approach in infertile women with endometriosis. There are different protocols for ovarian stimulation during in vitro fertilization (IVF) treatment. Wang et al, from China, published a study titled “Is the long-acting…

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Conventional IVF or ICSI: Which one is more accurate in endometriosis-related infertility?

Although the prevalence of endometriosis is 10-15% in the general population at reproductive age, it is diagnosed more frequently in infertile women with a prevalence of 25-40%. Although the exact mechanism explaining the association between endometriosis and infertility has not been elucidated, distorted pelvic anatomy, impaired ovarian function, altered microenvironment, affected endometrial receptivity and embryo quality have been proposed as the responsible mechanisms. Infertility in women with endometriosis is managed most commonly by assisted reproductive technology (ART) modalities including in…

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The most common gynecologic admissions to the emergency: Endometriosis and adenomyosis

Women with endometriosis demand therapy for the most common symptoms, which are pelvic pain and infertility. Adenomyosis occurs when the endometrial glandular and stromal tissue grows into the muscular wall of the uterus, called the myometrium. Women having adenomyosis also suffer from pelvic pain and heavy or prolonged menstrual bleeding. Medical or surgical treatment modalities can be suggested in the management of both endometriosis and adenomyosis. Dr. Xholli et al. from Italy published a study titled  “Gynaecological pathologies leading to emergency…

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Sexual function in infertile women with PCOS and endometriosis

Women with endometriosis suffer from several symptoms and signs including dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility which have a detrimental effect on their quality of life. Sexual dysfunction also is a common problem for endometriosis patients due to complex biological, psychological, social, and ethical issues. Polycystic ovary syndrome (PCOS), which is the most common endocrinological disease in reproductive-aged women also negatively affects sexual health. Daneshfar et al., from Iran, published a cross-sectional study titled “Comparison of sexual function in infertile…

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Endometriosis and the body perception

The most common endometriosis-associated symptoms are pelvic pain, dysmenorrhea, dyspareunia, and infertility. Women with endometriosis should be managed due to the significant impact of these symptoms on their quality of life. Body perceptions of these women are also affected depending on the visual and functional effects of the disease. A group of scientists from Australia, published a brief research report entitled “Endometriosis and body image: Comparing people with and without endometriosis and exploring the relationship with pelvic pain” in the…

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